Minimally invasive techniques for providing medical examinations and therapies frequently employ endoscopes, such as a bronchoscope, ureteroscope, or flexible sigmoidoscope. Endoscopes such as these typically employ fiber optic or CCD imaging devices to enable the practitioner to visually inspect otherwise inaccessible areas of the anatomy such as the lungs, the ureter and kidneys, the colon, etc. These endoscopes also typically contain a tube, called the working channel, through which solutions such as anesthetics can be administered and bodily materials such as mucus can be withdrawn, typically via suction. In addition to use in administering and removing liquids or other material, the working channel of an endoscope is used to pass slender instruments to perform other functions at the distal end of the scope, under visual guidance through the endoscope.
Instruments typically used in this manner include forceps for grasping objects or for pinching and removing small tissue samples, biopsy needles for removing deep tissue samples in the lumen of a needle, snares or baskets for capturing and withdrawing objects such as an aspirated peanut from the lungs or a kidney stone from the calyxes of the kidney, and a wide variety of other tools.
Manipulation of these tools requires simultaneous manipulation or stabilization of the endoscope, along with manipulation of the working channel tool itself. The endoscope can typically be maneuvered along three, four or more degrees of freedom, including insertion and withdrawal, rotation, and tip flexion in one or two dimensions (up/down and/or left/right). The working channel tool is maneuvered along an additional two or more degrees of freedom, including insertion/withdrawal, rotation, and tool actuation, etc. Tool actuation can include, for example, opening and closing the jaws of a biopsy forceps, controlling the plunge of a biopsy needle, actuating a cauterization or ablation tool, pulsing a laser, or opening and closing a snare or basket. The tasks of manipulating and stabilizing the three or more degrees of freedom of the endoscope, while simultaneously manipulating the multiple degrees of freedom of the working channel tool are difficult to perform, and frequently the practitioner uses an assistant to manipulate one or more of the degrees of freedom, such as working channel tool actuation.